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DICOM Imaging Software: What to Know if You are a Mac User

Dicom Imaging Software - Presented by PostDICOM

Medical imaging has progressed by leaps and bounds over the last few decades. Medical imaging today plays a vital role in the diagnosis and treatment planning of even simple conditions. With advances in the actual process of imaging, headway has also been made in the process of viewing, storing, and sharing images after their acquisition. One of the main achievements made in this regard has been the introduction of the DICOM standard.


Why do I need DICOM Software?

Medical professionals—whether they’re training, teaching, or practicing—have to deal with clinical images on a daily basis. DICOM, which stands for Digital Imaging and Communications in Medicine, is an internationally accepted file format for viewing medical images. Just like you would need a photo viewer to open JPEG images or a word processor for text documents, you need a specific application to view medical images such as CT scans, MRIs, and ultrasound images. Since these are very high quality and complex images (as required for diagnostic purposes), the respective software needs to be advanced enough to accommodate them.


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What Features should my DICOM Imaging Software have?

Most people tend to think of DICOM as only an application that you need to view images. However, there is so much more that can be done with DICOM viewer software today. That said, not everyone may require a fancy application with loads of features, so you should identify just what your needs are. This would depend on which of the following four categories of users you best fit into:

Medical Student or Resident: If you are just getting started, you are probably looking to learn how an anatomical structure looks like on a radiographic image or how a pathological process is identified and interpreted. For these purposes, you really do not need much more than a simple DICOM viewer software. Of course, it helps if you can view these images easily or share them with fellow students and teachers. For this, you need to check that images from a CD or USB drive can be directly imported into the software and that the images can be exported to other formats. If you need to prepare reports or presentations, a DICOM converter software will allow images to be converted to JPEG or PNG files.

Radiologist: If you are a full-fledged radiologist, you would definitely require an advanced DICOM workstation with multiple features. Any feature of the DICOM software that would enhance diagnostic accuracy would be useful. A few of the most important features that any radiologist must look for in DICOM imaging software are listed below:

  • Features that improve the quality of your image: Most DICOM software allow you to modify brightness, color and contrast to improve the quality of the images acquired.

  • Features that allow you to see beyond the initial acquisition: DICOM viewer software can reconstruct acquired 2D images into 3D images. Some applications can even slice the reconstructed 3D image, allowing you to view fresh angles. This feature is called multiplanar reconstruction.

  • Features that allow you to zero in on the area of interest: Some DICOM imaging software can isolate areas of maximum or minimum intensity projections. This distinguishes them from the surrounding normal regions.

  • Features that allow to get the best out of medical imaging: If your DICOM software is able to combine two or more imaging modalities, you can get the advantages of both. For instance, PET-CT scans allow anatomical visualization of metabolically active areas that are difficult to delineate with each modality alone.

  • Features that allow you to see function: There is usually a time lag between image acquisition and viewing by the radiologist. If your DICOM viewer software allows you to see images ‘real time’, you can monitor functional processes like swallowing or heart movements.

  • Features that allow storage and retrieval of images: Medical images are ideally stored in a server called PACS (Picture Archiving and Communications System). Generally, each hospital has its own internal PACS server. Your DICOM imaging software should be compatible with this PACS server in order to store and retrieve images from here. Some DICOM software come with their own mini-PACS servers.

Surgeon: As a surgeon, knowing what exactly to expect during surgery can be a big asset. Delineating critical anatomical structures beforehand can be a useful tool, and 3D and 4D analysis can help do this. Performing prior mock surgery simplifies the actual surgical process. Your DICOM imaging software must therefore allow you to perform or import files into an application that will let you perform mock surgery. Importing files in STL format is also a useful feature, as this format allows printing of stereolithographic models. This allows not only realistic mock surgery, but also enables stent fabrication and implant adaptation. Finally, a DICOM software that allows comparison of two images side by side can be a real advantage. By studying the preoperative and postoperative images side by side, it can enable evaluation of the accuracy of the treatment procedure.

Researcher: You could be a medical professional who is trying to put together a research paper based on medical imaging technology. Perhaps you need to go through medical images of multiple patients to extract pertinent data. In this case, you would require a DICOM viewer software that is compatible with the PACS server from which you will be accessing files. Ideally, you should also be able to import files into the viewer through either a CD or USB drive. You would also require a viewer that is capable of anonymizing patient data to protect confidentiality, as this is a requirement of ethical research. Advanced imaging features may also aid in research, especially calculations such as volumetric measurements and depth of invasions.


What DICOM Software is Best Suited for Mac Users?

Mac has a unique niche in the market. Several professionals prefer a Mac device because of its stability and easy-to-use interface. As a medical professional, one would prefer to rely on an operating system that is less prone to glitches and in general requires less maintenance. With more defence against viruses and hackers as compared to any other operating system on the market, Mac is better able to protect patient data confidentiality. However, around 75% of the world’s users still prefer other operating systems such as Windows, and accordingly, most DICOM application manufacturers have designed their software to be compatible with Windows. Nevertheless, there are a few applications out there that work equally well with Mac. We have listed the best options among these for you below:

PostDICOM

PostDICOM is definitely one of the best DICOM software available for the Mac operating system, irrespective of the main purpose that it is being used for. Best suited as a primary workstation in the radiology department, PostDICOM offers an array of advanced features that aid radiologists in making a diagnosis. These include multiplanar reconstruction, maximum, minimum and average intensity projections, image fusions, 3D volume and surface rendering.

PostDICOM offers its own PACS server in the form of cloud storage. Therefore, any images acquired from the patients can directly be uploaded to PACS and then can be accessed from anywhere with the right credentials, not just from the DICOM workstation in the hospital. The cloud-based PACS is safe, and patient anonymity can be obtained in cases of research. The DICOM software has a very simple interface that is easy for beginners as well as seasoned radiologists to operate. In addition to Mac, PostDICOM is compatible with Windows, Linux, Android and iOS, so medical imaging stored in the cloud PACS can literally be accessed from any device.

PostDICOM offers free cloud storage up to 50 GB. It also allows one free user account (that must be used on all devices) and sharing of ten files per month with other users. If you need more storage space, or more accounts to access the files from, you will need to take a paid subscription. The paid subscription also allows more files to be shared each month.

Osirix/Horos

While Osirix is aimed at practicing radiologists, Horos is designed for students who are learning radiology or preparing for exams.

Osirix MD claims to be a complete medical imaging workstation for any radiology department. It is easy to install, and can be integrated with any PACS server. It offers advanced post-processing techniques, including MPR, MIP, volume and surface rendering. It also allows curved reconstruction, which can help trace vessels such as the aorta or bronchi. It supports 2D image viewing and also offers 4D image support such as cardiac acquisitions.

Osirix has FDA approval for diagnostic imaging in medicine. It also has a CE label and is considered a Class IIa product. A trial version of this, Osirix lite, is available for free. However, it is a demo version, and all images are generated with a watermark. It is not licensed and hence not meant for medical use.

Horos is open-source, licensed software designed by radiologists in the UK and it is continually improved and updated. Unlike Osirix lite, it offers multiple advanced features, including MPR, 3D MIP, 3D volume rendering, image fusion, and other measurement tools.

Horos offers plenty of support to new users, both free and paid. They provide a four-part video tutorial, as well as a detailed user guide. In addition, they also offer paid support where you can work one-on-one with an expert.

Horos offers cloud-based storage of images, from which reports can be generated and shared. The free subscription allows creation of five reports and five shares per month. This can be upgraded for a fee. The reports can be customized to suit individual practice needs. Horos also offers an Osirix migration assistant, should you wish to switch over to this application instead, without losing your saved features and data.

Miele LXIV

Miele LXIV is another free DICOM viewer that has been designed exclusively for Mac users. It allows integration with all PACS servers. It can also easily import DICOM files from a CD drive. Like Horos, it offers advanced features, including MPR, MIP, 3D volume rendering, image fusion, and 4D imaging of cardiac scans. It generates interactive 3D models which allow for better anatomical orientation and treatment planning. Images can also be exported to other Mac applications. This application is available in seven different languages, so it can be used by professionals across the globe. The software is completely free for non-commercial use.

mRay DICOM Viewer

This is a free DICOM software for Mac, designed by a German company, and is compatible with the Mac operating system. The application was actually primarily designed to work on mobile devices, including iPad and iPhone. A single app on the mobile device helps physicians to connect to the PACS and view patients’ medical images. However, the manufacturers have cautioned that viewing medical images on mobile devices must be for informational purposes only, and for diagnostic purposes, a regular DICOM workstation must be used. This viewer offers MPR, but does not offer many other advanced features.

mRay can be integrated to PACS only through an mRay server. While the viewer itself is free, the mRay server is free only for a limited trial period after which payment is required.

3Dimviewer

The 3Dimviewer is a free DICOM software that is compatible with multiple operating systems, including Mac. It is a free license software that originates from the Czech Republic. This advanced DICOM software has features like MPR, MIP, and image fusion. It does not allow for exporting into simpler image formats. It is lightweight and has a very easy-to-use interface. So, if you are just getting familiar with DICOM applications, it is a great software to try.

Weasis

Weasis is a recently released, powerful application that is compatible with the Mac operating system, as well as others such as Windows and Linux. It can be integrated to multiple PACS servers. Although it allows 3D reconstruction, multiplanar reconstruction, and MIP, it does not support image fusion. It does allow measurement of SUV and has the ability to create structured reports. One unique feature of Weasis is that in addition to medical images, it is compatible with ECGs. This would be useful for clinicians such as cardiologists and general practitioners to get an overall picture of cardiac function. It allows importing of files to picture formats such as JPEG and PNG. Weasis claims to offer support in multiple languages. The DICOM software is completely free for non-commercial use.

Of the above, we have found that PostDICOM software for Mac ranks a cut above the rest. With superior speed, ease of use, and advanced features, it makes radiological diagnosis a smooth and accurate undertaking. PostDICOM is the only application that allows Mac users a free cloud-based PACS server. Since the DICOM software is free, you should just go ahead and give it a try today!

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